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Pomalidomide - Pomalidomide capsule
Blue Cross and Blue Shield of Kansas (MCO)
Blue Cross and Blue Shield of Kansas (MCO) Coverage for Pomalidomide - Pomalidomide capsule
All
6
Commercial
2
Health Exchange
2
Medicare
2
Commercial
Commercial - HMO
No PA
No Step Therapy
No Quantity Limit
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Commercial - PPO
No PA
No Step Therapy
No Quantity Limit
See Details
Health Exchange
Health Exchange - HDHP - Health Insurance Exchange
PA Required
No Step Therapy
No Quantity Limit
See Details
Health Exchange - PPO - Health Insurance Exchange
PA Required
No Step Therapy
No Quantity Limit
See Details
Medicare
Medicare - Prescription Drug Plan
PA Required
No Step Therapy
Quantity Limit
See Details
Medicare - Medicare Advantage Part D
PA Required
No Step Therapy
Quantity Limit
See Details
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